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People who mistrust vaccines are unlikely to change their attitude based only on scientific evidence that recommends them, according to an international survey that finds motivations to reject scientific consensus go deeper than a person’s educational level.

The study, which surveyed 5,323 people in 24 countries, revealed that people who are against vaccines or distrust their effectiveness are more inclined to believe in conspiracies, to feel rebellious or different, or to maintain unpopular attitudes such as being skeptical of the climate change.

People with anti-vaccine views tend to be “suspicious of pharmaceuticals and [imperialist] interventions, [and] also enjoy feeling different because they have a minority opinion”, said Matthew Hornsey, from the University of Queensland in Australia and lead author of the article, in an interview with SciDev.Net.

They tend to be more averse to needles and blood. “To be anti-vaccines is a way to avoid something that causes anxiety”, says Hornsey. Education, on the other hand, does not make a real difference to attitudes on vaccination, he points out.

“You only need a small number of people that don’t get vaccinated in order to lose the ‘collective immunity’ that makes diseases reappear”

Matthew Hornsey

The survey, published in the journal Health Psychology, assessed attitudes based on four criteria:belief in conspiracies, non-conformist behaviour, dislike of needles and blood, and individuality of thought.

For each of these criteria, the respondents were asked to choose a response from a range between 1 to 5, where 1 meant ‘I strongly disagree’ and 5 meant ‘I strongly agree’. For example, to assess their belief in conspiracies, people had to choose their agreement to sentences such as ‘Princess Diana was murdered’, or ‘the US government knew about the attack on the Twin Towers and let it happen, or ‘the world’s elite are trying to create a New World Order”.

Sentences used to assess anti-vaccine attitudes included “Children get more vaccinations than are good for them”, or “a vaccine might not prevent the disease”.

The researchers then correlated the degree of agreement with each statement and combined the four elements into a single scale in order to produce an average measure of attitude per citizen in each country. Citizens of each of the four Latin American countries included in the survey (Argentina, Brazil, Chile and Mexico) showed higher levels of belief in conspiracies and anti-vaccine attitudes than the average across the 24 nations surveyed. But the relationship between both these criteria turned out to be lower in Latin America than in other industrialised countries such as Canada, Germany and New Zealand.

“It is possible that this relationship could be stronger in ‘rich’ countries since they have better Internet access, and [that is where] conspiracy communities live and prosper,” suspects Hornsey.

Josefina Brown, a health and population researcher at the University of Buenos Aires who has analysed how anti-vaccine movements behave through social media in Argentina, told SciDev.Net that new technologies allow individualistic tendencies to diffuse at a very low cost, and fuel doubts about the authority of doctors.

“In websites, both the content and the images try to feed several social fears using attention-grabbing and negative terms,” Brown said. But at the same time, users demand more information about the benefits and risks of vaccines “in order to justify the arbitrary interference of the State when it compels people to get vaccinated against their will”, she added.

In Brazil, the Ministry of health has found several Facebook groups that have reached more than 13,000 followers as of 2017. These are fora where parents with anti-vaccine sentiments have shared blog posts — the majority of which are from other countries and in English — about alleged reactions to vaccines such as autism.

These groups seem to be achieving success in their anti-vaccine campaigns: in 2017, only 76.7 per cent of children in Brazil received the second dose of the MMR vaccine that protects against measles, mumps and rubella, according to the Ministry of Health.

The risk that results from people getting convinced that vaccines are ineffective is that both adults and children stop getting immunised. “You only need a small number of people that don’t get vaccinated in order to lose the ‘collective immunity’ that makes diseases reappear,” Hornsey explains.

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